Provider First Line Business Practice Location Address:
1243 SW TOPEKA BLVD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66612-1907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-783-7691
Provider Business Practice Location Address Fax Number:
785-783-7692
Provider Enumeration Date:
10/17/2008